Cognitive-Behavioral Therapy

What is cognitive-behavioral therapy?

Cognitive-behavioral therapy helps you change how you feel by helping you change how you think and react. What you say to yourself affects how you feel. When you're not aware of what you're saying to yourself, thoughts can go around and around in your head and can lead to depression or anxiety. CBT helps you:

• Change your thoughts, beliefs, ideas, attitudes, mental images, and what you pay attention to. This is the cognitive, or thinking, part of CBT.
• Face the challenges in your life calmly, and then take actions that are likely to have good results. This is the behavioral, or action, part of CBT.

Cognitive-behavioral therapy is different from other kinds of therapy in several ways. It is:

• Goal-oriented: It will help you define your goals, plan ways to accomplish those goals, and check your progress.
• Short-term: Depending on your problem and how hard you work to change your thoughts and behaviors, goals can usually be achieved in less than 20 sessions.
• Self-help oriented: CBT focuses on helping you learn ways to manage your life better.

CBT can help you feel better without using medicine. It can also be used along with medicine. CBT can help with:

• anxiety
• depression
• eating disorders
• obsessive-compulsive disorder
• panic attacks
• phobias
• post-traumatic stress
• problems with relationships, family, work, and school
• self-esteem

How does CBT work?

At the start of therapy, you learn to look for distorted thinking. For example, if you don't trust other people, you might have thoughts like, "Everyone is out to get me," or "People just want to take advantage of me whenever they can." These thoughts are familiar and have become automatic. These thoughts are called "distorted" because they are not based on what is really true, but are based on old beliefs left over from a bad experience. They can also come from messages that you got from other people in the past.

In therapy, you learn to argue with your own distorted thoughts. You also learn to replace them with healthier or more correct thoughts. The end result is a change in how you feel.

For example, you may find yourself thinking repeatedly that "Everybody hates me." You then notice that you feel sad after thinking this thought. This results in low self-esteem. During CBT, you would learn to change or argue with "Everybody hates me." You might think to yourself, "Well, I do have at least 4 friends, so some people do like me." After thinking this new thought, you might feel hopeful. The new result is higher self-esteem.

You will also learn new skills, such as taking part in activities that you have avoided, decreasing bad habits, learning new people skills, and improving how you manage stress.

What happens during a typical therapy session?

One of the first things your therapist will do is to find out how you've been feeling and what has changed since your last session.

The therapist will ask you what problem you'd like to work on during the current session.

Next, you and the therapist will talk about the problems you identified. You will check the accuracy of your thoughts and beliefs and come up with ideas for problem-solving.

You and the therapist will discuss how you can make best use of what you've learned in your daily life (between sessions). The therapist will go over the important points of the session and ask you for feedback.

How do I find a therapist who can do this therapy?

Therapists who do CBT usually mention it in their advertising. If someone recommends a therapist, ask the therapist about the type of therapy they do. You can also check with:

• your healthcare provider
• friends or family members who have been in therapy
• local associations of psychologists, social workers, or counselors.